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目的:了解临床分离肺炎克雷伯菌(Klebsiella pneumonia,KPN)和产酸克雷伯菌(Klebsiella oxytoca,KOX)对抗菌药物耐药性变迁情况和分布情况,用以指导临床用药和医院感染防控。方法:对2013年1月—2015年12月徐州医科大学附属医院细菌耐药监测资料中临床首次分离KPN和KOX菌株的耐药性进行分析,细菌鉴定与药敏试验采用Phoenix 100全自动分析系统,数据采用WHONET 5.6软件分析。结果:共分离出1 920株KPN(12.0%)和87株KOX(0.5%),送检标本以痰液标本为主(76.5%),送检科室以重症监护病房(intensive care unit,ICU)为主(43.9%),二者总体检出率以秋季最高(26.7%),冬季最低(22.0%)。二者对阿米卡星、亚胺培南、美洛培南耐药率最低,KPN分别为19.0%、19.8%、30.4%,KOX分别为17.0%、2.0%、8.6%。结论:3年间临床分离的KPN和KOX对常用抗菌药物的耐药性上升趋势明显,临床医生应根据药敏结果结合临床感染情况合理选择抗菌药物,有效控制耐药菌株感染的发生和流行。
OBJECTIVE: To investigate the changes and distribution of antimicrobial resistance in Klebsiella pneumonia (KPN) and Klebsiella oxytoca (Klebsiella oxytoca) isolates from clinically isolated clinics and to guide them in the prevention of nosocomial infections control. Methods: The antibiotic resistance of KPN and KOX strains isolated for the first time in clinical drug resistance surveillance data of the affiliated hospital of Xuzhou Medical University from January 2013 to December 2015 were analyzed. Bacterial identification and drug sensitivity test were carried out with the Phoenix 100 automatic analysis system , Data using WHONET 5.6 software analysis. RESULTS: A total of 1 920 strains of KPN (12.0%) and 87 strains of KOX (0.5%) were isolated. Sputum samples were mainly collected (76.5%) in the specimens tested. The intensive care unit (ICU) (43.9%). The overall detection rate of both was the highest in autumn (26.7%) and the lowest in winter (22.0%). The resistance rates to amikacin, imipenem and meropenem were the lowest, KPN were 19.0%, 19.8% and 30.4%, KOX was 17.0%, 2.0% and 8.6% respectively. CONCLUSION: The resistance of commonly used antibiotics to KPN and KOX clinically isolated in three years shows an obvious upward trend. Clinicians should select antibiotics reasonably according to their susceptibility and clinical infection, and effectively control the occurrence and prevalence of drug-resistant strains.